Practice Management Considerations for Pseudophakic Monovision

Pseudophakic monovision aims to provide excellent unaided vision following cataract surgery for presbyopic patients using conventional monofocal IOLs and targeting one eye for distance and the other for near.  The surgeon aims for emmetropia in the dominant eye and myopia in the nondominant eye.  The degree of spectacle independence depends on the patient’s tolerance for myopic defocus and interocular defocus.

Pseudophakic monovision is not appropriate for everyone; monovision is a compromise.  Vision is not perfect either up close or far away, stereopsis is diminished, and spectacles may still be required for some tasks.  Carefully selected and motivated patients achieve high levels of satisfaction.

This FAQ addresses the following:

  1. What is pseudophakic monovision?
  2. How does the surgeon evaluate patient suitability for pseudophakic monovision?
  3. Does Medicare cover preoperative testing for pseudophakic monovision?
  4. Does the beneficiary need to sign an Advance Beneficiary Notice (ABN) for preoperative testing?
  5. How should preoperative testing be coded on claims?
  6. Is preoperative testing for pseudophakic monovision bundled with any other services?
  7. How often may these tests be administered?
  8. What is the reimbursement for refraction?
  9. Are there other charges associated with pseudophakic monovision?

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